Market Insight

CMS to cover lung-cancer screening with low dose CT

March 02, 2015

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The Centers for Medicare and Medicaid Services (CMS) has recently announced plans to provide immediate coverage for the use of low-dose computerized tomography (CT) for lung-cancer screening in the United States. This is already covered by many private medical insurers, because of the benefits associated with early intervention in cancer treatment. Coverage by CMS extends this service to those who cannot afford private medical insurance but are covered by the Affordable Care Act, estimated to have been 15 million people at the end of 2014. According to the American Lung Association, lung cancer remains the premier cause of cancer deaths in the United States, with over 220,000 new cases predicted to be diagnosed in 2015, and over 155,000 predicted deaths. 

Our analysis

Cost containment and equipment utilization remain a key focus in the U.S. market, and has led to reduced reimbursement for CT equipment in recent years. This extension of CMS coverage for CT, particularly in a patient population that otherwise would not have been able to afford it, will drive manufacturers to develop their product offerings to cater to this application. However, IHS predicts that this change in legislation will not fuel new system growth in the CT market, as healthcare providers will use existing devices to increase patient throughput. Growth of the new systems market is further limited by the implementation of the American Tax Payer Relief Act in 2012, requiring CT use of at least 90 percent to ensure reimbursement. Consequently, major growth opportunities will remain limited due to the specificity of the application. 


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